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Key Learning Points

1. Coagulopathy is common in the ICU and abnormal results should be interpreted in the context of the patient’s clinical condition.
2. Conventional coagulation tests monitor the intrinsic and extrinsic pathways of coagulation and are the mainstay of haemostatic monitoring.
3. Full blood count and conventional coagulation tests have a turnaround time that renders them unhelpful in acute bleeding scenarios.
4. Point-of-care viscoelastic tests, such as thromboelastography (TEG®) and rotational thromboelastrometry (ROTEM®), can provide a rapid overview of coagulation from clot formation to lysis, demonstrating both hypo- and pro-coagulant states.
5. Algorithms based upon viscoelastic tests in bleeding patients have demonstrated a reduction in blood transfusion requirements.

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